Abstract
BACKGROUND: Eye‒hand coordination (EHC) integrates cognitive and motor processes and is important for daily functions in older adults. Poor EHC performance is often associated with a decline in cognitive function, namely, executive function and attention, as well as a decline in motor function. However, their relationship remains unclear. OBJECTIVE: To examine the associations among executive function, attention, global cognition, muscle strength, and EHC performance in elderly individuals. METHODS: In this cross-sectional study, 213 community-dwelling older adults (median age 71 years, IQR 65.5–76.0) underwent assessments of executive function (Shape Trail Test Part B, STT-B), attention (Digit Cancellation Test, DCT), global cognition (Montreal Cognitive Assessment, MoCA), EHC reaction time and accuracy (EHC-RT, EHC-ACC), right shoulder flexion strength (rSFS), and right hand grip strength (rGS). Mediation analyses were conducted via PROCESS Model 4 with 5,000 bootstrap resamples (95% CI). RESULTS: STT-B score was associated with EHC-RT (ρ = 0.32, p < 0.001) and remained an independent predictor of EHC-RT (β = 0.17, p = 0.03) after adjusting for other variables in a linear regression model. Significant indirect effects of STT-B on EHC-RT were observed via DCT (β = 0.09, 95% CI [0.03, 0.17]; 23.50% of the total effect), MoCA (β = 0.18, 95% CI [0.08, 0.30]; 49.73%) and rSFS (β = 0.05, 95% CI [0.01, 0.10]; 13.11%). Chain mediation analysis revealed a serial association from the STT-B via DCT and the MoCA to the EHC-RT (β = 0.03, 95% CI [0.00, 0.06]). Direct effect remained significant. CONCLUSION: Executive function was associated with EHC-RT, with attention, global cognition, and shoulder flexion strength acting as partial statistical mediators. Longitudinal or interventional studies are needed to test causal pathways. TRIAL REGISTRATION: Chinese Clinical Trial Registration Center, No. ChiCTR2300073086. Registration date: June 30, 2023. https://www.chictr.org.cn/. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-026-07339-4.